I-Dementia ehlangene ne-HIV kunye nabanye
Njengoko igama layo libonisa, i -virus yomzimba (i-HIV) inokukhusela isistim somzimba. INTSHOLONGWANE KAGAWULAYO ihlasele ngokuthe ngqo iiseli zomzimba ezibizwa ngokuba yi- CD4 ezilungileyo ze-T Njengoko la maseli efa, umzimba uya kulungelelaniswa kwizifo kunye nosomhlaza ukuba abantu abanempilo baya kukwazi ukulwa.
Oko abanye abantu abangaqapheliyo kukuba intsholongwane kaGawulayo ngokwayo ingabangela iingxaki ezinzulu ngaphandle kokuba ezinye izifo zibandakanyeke.
Enye yale ngxaki i- HIV-Associated Dementia (HAD) , eyaziwa ngokuba yi-HIV encephalopathy okanye i-AIDS dementia complex.
Nangona kwakuye kucingelwa ukuba kwenzeke kuphela kwi-HIV ephambili, ngoku sibona kubantu abaye bazinzile kwiimichiza zabo kwaye banamaxabiso aphezulu e-CD4.
Izifo ezibangelwa yi-HIV-Associated Neurocognitive Disorders
Iindidi zeengxaki zokuqonda ezinxulumene ne-HIV zikhona kwiinkalo zobunzima. Xa kuqwalaselwa ndawonye, ezi ntlobo zokukhubazeka zibhekiswa njenge-HIV-Associated Neurocognitive Disorders.
Inxalenye encinci ye-HIV-echaphazelekayo ne-Neurocognitive Disorder ibonakalisa ukukhubazeka okungavumelaniyo, apho umntu ebeka kakubi kwiimeko zokuvavanya i-neuropsychological, kodwa ubomi babo abuchaphazeli. Ukuba ubomi bomntu bunempembelelo kodwa kungabalulekanga, ezinye iiklinikhi ziza kugqiba isigulane ngesifo esincinci-senjini (MCMD).
Ukuba le ngxaki iyabonakala kwiindlela zokuvavanya i-neuropsychological kwaye iphazamise kakhulu ubomi bemihla ngemihla, ukuxilongwa kungenziwa nge-HIV-Associated Dementia.
Iimpawu ze-HIV-Associated Dementia
Abantu abaninzi bacinga ukuba i-HIV-Associated Dementia (i-HAD) iya kufana neefom eyaziwayo kangcono zengqondo efana ne-Alzheimer's disease.
Oku akuqhelekanga kwimeko. Nangona imemori ingakwazi ukuphazamiseka njengoko inokuthi isifo sesifo se-Alzheimer, abantu abane-HIV-Associated Dementia banokuba nzima ukugxila okanye ukunyamekela ingqalelo, engabonakali rhoqo kwisifo se-Alzheimer. Abantu abane-HIV-Associated Dementia nabo bancipha ngakumbi kunokuba babeza kuba, kungekhona nje ekucingeni, kodwa ngokuphindaphindiweyo ekuhambeni. Ngale ndlela, ukugula komzimba ngenxa yentsholongwane kaGawulayo kunokulinganisa isifo sengqondo sikaParkinson (PDD).
Abantu abane-HAD nabo banokutshintshwa kwimoya yabo njengokunganakwa, apho bengenasisiseko sokwenza into eninzi. Njengoko eso sifo siyaqhubeka, sinokucatshukiswa ngakumbi, kwaye ama-5 ukuya kwe-8 ekhulwini avelisa i-AIDS mania kunye neempawu zengqondo ezifana ne-paranoia kunye ne-hallucinations.
Isizathu SENDLELA
Intsholongwane kaGawulayo ingena kwinkqubo yesistim ephakathi (CNS) kungekudala emva kokusuleleka. Nangona ubuchopho bukhuselwe yichungechunge lweetyhuthwa ezibizwa ngokuba ngumqobo weengcambu zengqondo , amanye amaseli omzimba, njengama- macrophage , angafikelela. Oku kwenza umlinganiselo othile wokuqonda. Ngokuqhelekileyo, ezi seteli zisetyenziselwa ukulwa nesifo. Kodwa-ke, i-HIV, okwenene, isithintelo. Kufana nokugqoka njengekhuseleko ukuze udibanise kwinqaba.
Ngesinye isengqondweni, intsholongwane ayifaki iiseliti zesisongela ngokwabo kodwa ibonakalisa ngokuthe ngqo ngokubangela impendulo yokuvuvukala.
Iimpawu zobungozi ze-HAD
Imiba enkulu yengozi ye-HAD ibandakanya ukunyanzeliswa kakubi kumachiza e- antiretroviral kunye nomthwalo wentsholongwane . Ubude bexesha apho umntu osulelekileyo une-HIV kubaluleke kakhulu kunokuba ixabiso le-CD4 yabo liphantsi kangakanani.
Ukuvavanya kwi-HAD
Ngenxa yokuba i-HIV yenza abantu banamathele kwezinye iingxaki ezinokubangela ukuba utshintsho lweenkqubela, ezifana nokusuleleka kunye neengqungquthela, uvavanyo oluchanekileyo lubizwa xa umntu onentsholongwane kaGawulayo eguquka ngendlela abacinga ngayo.
Oku kunyanisekileyo xa umntu ehamba ngokukhawuleza. Uninzi lwe- dementias lucotha, kwaye inkqubo yokukhawuleza ithetha ukuba kukho ingxaki eyahlukileyo, okanye ukuba i-HIV iphuma ekulawuleni.
I-Workup ye-HIV yengqondo ye-HIV kufuneka ifake i- MRI yengqondo ukujonga iimpawu zentsholongwane okanye umhlaza. I-dementia echaphazelekayo ne-HIV ngokwayo ibangela utshintsho oluphawulekayo kumfanekiso wengqondo ethathwe yi-MRI. Ingqondo ingabonakaliswa ukuba iyancipha, kwaye kukho inani elinyukayo leempahla ezixhamliweyo, ezibalaseleyo apho zingabakho.
Unyango lwe-HAD
Njengezinye iindidi zeengxaki zokugula komzimba, akucaci ukuba yintoni, ukuba kukho na, unyango lunokunceda umntu onentsholongwane ka-HIV. Esinye seziyeza esasetyenziswa ngokusesikweni kwi-Alzheimer's disease, iMemantine, isiqinisekisile ukuba asiyi kunceda, kwaye akukho sizathu sokukholelwa ukuba ezinye iimyeza ezisetyenziselwa i-Alzheimer ziya kuba luncedo.
Ukunyamekela kakuhle kwi-antiretroviral therapy kuye kwadibana neengozi ezincinci ze-HAD, kodwa kuncinci ukuba ingaba ukongeza okanye ukuguqula imishanguzo kumntu ono-HAD kunanoma yintoni inzuzo. Kwisifundo esinye, ukuguqula imishanguzo ye-antiretroviral imiphumo eyenza abantu babi kakhulu. Nangona kunjalo, ukuba umntu unento enxulumene ne-HIV-Associated Dementia, abantu abaninzi baya kutshintsha amayeza, ingakumbi ukuba imishishini isigulane isaziwa ngokungena kwinkqubo ye-nervous central (CNS). Imithi efana ne-tenofovir, i-zalcitabine, i-nelfinavir, i-ritonavir, i-saquinavir kunye ne-enfuviritide yonke iboniswe ukuba ikwazi ukungenelela kwi-CNS, nangona uncedo lwaloo mnyango luhlala lukhutshwe, kwaye lunokwenzakalisa ingozi ngaphezu kokulungileyo.
Abanye abantu basebenzisa i-methylphenidate (Ritalin) ukuncedisa ukucotha kwengqondo. Ngokubanzi, ukuhlala ngengqondo, kwintlalo nangokwenyama kucebise.
Ingxaki yeengxaki ze-HIV yingxaki enkulu, kwaye ngelishwa, asikwazi into eninzi ngayo. Ngokungafani nezinye iindidi zeengqondo zomzimba, abantu abaneentsholongwane ze-HIV bahlala bephucula, kwaye ke kubalulekile ukuxoxa ngale mpawu ngugqirha ofanelekileyo.
Imithombo:
U-Antinori A, Arendt G, Becker JT, et al. I-neoloji yophando olongezelelweyo lweengxaki ze-HIV ezinxulumene ne-HIV. Neurology 2007; 69: 1789.
Iimenenzana kunye neenkcazo zecandelo lophando lweembonakalo ze-neurological of human immunodeficiency virus-type 1 (HIV-1). Ingxelo yeqela elisebenza kwi-American Academy ye-Neurology AIDS Task Force. Neurology 1991; 41: 778.
Xabiso RW. Iingxaki zeengxaki ze-HIV. Lancet 1996; 348: 445.